Provider Demographics
NPI:1760270078
Name:JIBILIAN, CHRISTINE ALICE (MASTERS STUDENT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ALICE
Last Name:JIBILIAN
Suffix:
Gender:
Credentials:MASTERS STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 860
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:VA
Mailing Address - Zip Code:24531-0860
Mailing Address - Country:US
Mailing Address - Phone:434-421-0891
Mailing Address - Fax:855-233-1727
Practice Address - Street 1:300 FRANKLIN ST STE 242
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-1802
Practice Address - Country:US
Practice Address - Phone:434-421-0891
Practice Address - Fax:855-233-1727
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor